50% of children in areas of high disadvantage not ‘school ready’ at age five
Source: ‘First 1000 days of life’ report, 2019
Children who have a poor start in life tend to feel the repercussions throughout their existence.
Adverse Childhood Experiences – such as violence or substance abuse within the home, parental separation, incarceration or mental health issues – result in poorer health, a lower socioeconomic status and even an earlier death, as explored last issue.
However, this is not restricted to older children as may be easier to grasp: this starts from the day of conception.
The ‘First 1,000 Days’ study was commissioned by the government in an attempt to address the inequalities in people’s lives and reduce the adverse effects on people’s future wellbeing.
It covers the first 1,000 days, which runs from conception to the age of around two.
This is a critical phase, as it’s when the building blocks of body and brain development are formed: if they’re formed well, life chances tend to be good.
If children are failed at this point, their futures have already been dealt a huge blow.
People can appreciate the results of mothers smoking, drinking alcohol or taking illicit drugs during pregnancy: we can comprehend that cell growth could be inhibited or changed in some way.
However, an unhealthy increase in stress hormones, such as cortisol, released due to extended levels of tension, can also affect the cellular level of a foetus, not only causing miscarriage, but foetal growth retardation, premature birth and postnatal delays (Poggi-Davies & Sandman, 2006).
However, the effects of poor housing or poverty are less overt.
A simple example can be toilet training and substandard housing. Potty training is miserable enough, but add a lack of heating or hot water, or no washing machine or garden.
Throw in a hungover, distracted or aggressive parent, and it’s easy to see why many children are entering school not toilet trained.
The parent is disadvantaged by having to spend scarce resources on nappies, but the child has failed to hit another milestone and risks missing / being sent home from school, plus negative reactions from staff and peers.
Instead of being educated and socialised, valuable time is spent on something that could have been done in the home two years prior.
The food choices a child has during weaning can reflect those throughout their lives. A child fed a range of healthy foods is likely to continue, and their health will benefit accordingly.
A parent who has little money, inadequate cooking facilities or a lack of education about the importance of diet, may be more likely to use convenience or junk food, which will not only direct their child’s life palate, but may also result in a failure to thrive.
In addition to this, many stresses during the First 1,000 Days are not related to a woman’s socioeconomic standing.
Domestic abuse or mental illness are often hidden from health workers: those women who have the outside appearance of coping (especially if they are not first-time mums) will be expected to manage, but their lives may be more chaotic than realised.
So, where do nurseries enter the equation? Foremost is being aware of the First 1,000 Days’ crucial role in the health of a foetus and young child.
Most nursery staff will know that fresh air, exercise, healthy snacks and meals, and happiness all contribute massively to a child’s health.
However, when you know that it will also reflect their future wellbeing, it adds a different level of responsibility.
Looking after the parent too may feel like it’s out of your remit, but if you can see it as an extension of the child’s wellbeing, then it may be more comfortable.
Nursery staff often have a close relationship with parents and are far more likely than healthcare professionals to know what’s really happening in their lives.
Have a member of staff who’s interested in such things as the go-to person for wellbeing. Get them informed about what initiatives are available locally, so that parents who are struggling can be signposted on to formal support.
Have a noticeboard where parents gather, and plaster it with posters about what constitutes domestic abuse. Have names and contact details about housing issues and mental health services.
Give information about how foetuses and children are affected by parents with alcohol and substance misuse. Offer health visitors the ability to send leaflets, etc about issues that affect children so that you can give them out. If you believe parents are struggling, ask if you can pass on their details.
There are also less-altruistic ways to be involved. The government wishes to harness the contacts, relationships and expertise that organisations such as nurseries already have with families.
Partnership opportunities are available between government agencies and the private sector which might provide an alternative income stream.
Physical ‘hubs’ are being sought in buildings that the targeted users already visit: if you have an underutilised area that could be separated off as a consultation room for organisations to speak with, say, parents needing family support, these could be hired out.
This need only be a private space for a couple of chairs; it just allows people to go in through a door marked Nursery rather than Domestic Abuse Services.
Free training may be available to upskill staff to allow you to offer more specialist services that may attract a higher price or make you more competitive.
Being involved in public initiatives alongside your own services – such as A Better Start in England, or Flying Start in Wales, can regulate your income and provide more security.
The scene of early care is changing, and the focus will be on prevention rather than cure. The whole family will be the target, rather than the squeaky wheel that may previously have been a suffering child.
Nurseries that can align themselves with this stand a better chance of being involved at an early stage, and not just helping the families they serve, but establishing themselves as key figures in efforts to improve child welfare.
Lorraine Jenkin is an author who has been involved in childcare for several years.